This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Our specific aims are to test the following hypotheses: There is a distinct population in the Los Angeles South Bay area that have insulinopenic DM-2, identifiable by their presentation with ketoacidosis Syndrome of Ketosis In Type 2 Diabetes, SKIT-2. Our first aim is to test the hypothesis that these patients represent a distinct epidemiological subgroup within the larger patient population of type 2 diabetes mellitus. We hypothesize that patients with SKIT-2 will continue to show insulinopenia at follow up over 3 months after DKA, when compared with matched DM-2 subjects who have not experienced ketoacidosis. This will be tested using psychological studies of insulin secretion and sensitivity. In these studies we will focus upon Hispanic subjects so as to obtain a degree of homogeneity in the subjects studied. Some subjects will have a mutation in a known diabetes gene. This will be assessed by screening SKIT-2 probands for mutations in mitochondrial DNA and HNF-1alpha. HLA typing of probands will also be done once this project is funded. Until then, DNA will be stored and/or lymphocytes will be obtained and transformed for later study.